4 - (IOP 14) Impact of a Mobile App-based Waitlist Intervention on Readiness for Eating Disorder Treatment: Protocol for a Randomized Controlled Trial

Eating disorders (EDs) are life-threatening illnesses often marked by considerable delays in treatment initiation, with some patients waiting years for care. Longer waitlist duration has been tied to higher dropout rates, increased symptom severity, and lower treatment engagement. To address these challenges, brief pre-treatment interventions—particularly those grounded in Motivational Interviewing (MI)—have emerged as promising strategies for reducing the negative impact of prolonged wait times. Recent shifts toward app-based interventions offer new opportunities to deliver MI principles at scale, with preliminary evidence suggesting that digital MI interventions may improve motivation, confidence, and readiness for change in patients awaiting formal treatment.

Building on these insights, the MI-Coach: ED mobile application—a self-guided program that delivers modular MI content through interactive exercises, videos, and educational articles tailored to an ED population—was developed and pilot tested with a Canadian sample of waitlisted ED patients in British Columbia. The pilot demonstrated high feasibility, acceptability, and preliminary improvements in users’ confidence to change disordered eating behaviours. The present protocol (ClinicalTrials.gov identifier NCT06801197) outlines a two-phase randomized controlled trial (RCT) to evaluate MI-Coach: ED in a larger waitlisted ED sample (n = 74) from four provincially funded programs in British Columbia. In Phase 1 (Weeks 0–4), participants will be randomized to either (1) an active treatment group using the app for four weeks or (2) a delayed treatment control group remaining without intervention before receiving app access. In Phase 2 (Weeks 5–12), the delayed group will merge with the active group, and all participants will continue using MI-Coach: ED. Both groups will complete assessments at baseline, four-, eight-, and twelve-weeks evaluating ED pathology, motivation, anxiety, depressive symptoms, and body image, with brief readiness-to-change questionnaires administered weekly. Recruitment for this RCT is currently underway.

Linear growth modeling will be employed to examine changes in motivation and clinical outcomes over time. Broadly, this study aims to evaluate whether an app-based MI intervention can sustain or improve readiness to engage in ED treatment while mitigating risks associated with lengthy waitlists, including dropout and symptom exacerbation. Findings may inform policy on pre-treatment support, guide further research on scalable interventions, and ultimately advance efforts to reduce barriers and improve outcomes for individuals seeking ED treatment.